BP12379BUILDING PERMIT APPLICATION
~'~Jr ~~ Jurisdiction of City of Blair, Nebraska
P Fee: ~~` fie ®G , 218 Sou Street
Issuance Fee: ~~ ~ ~~ add. Dc~~~ Blair ebraska 12 3 7 9
Receipt #: -402) 426- 191 • ax (4 426 1 ermit
Deposit Receipt #: ~ f .~ ~~ `~9~'
Issue Date: ~ ~~ ~ ~ ~ Type: ~ ~
JOB ADDRESS r {~
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LEGAL
1 . DESCR. SEE ATr SHEET
2 OWN ~ D AIL A DRESS ZIP HOM PHO ~ ~ .
WOR CE H E
3. CONT 0 r /Ja
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" A J„~DDR~S
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7 ZI yyOR CE NE ONE ~J~/- ~~~a
4. Class of Work: ~ NEW
W Q ADDITION ^ RE
M
0
DEL ^ OTHER 0 FINIS ED BA MENT ^ UNFINISHED BASEMENT
5. Describe Work: ~ f ~~~ Q ~~v ~~ ~ ~~~ j ~ ~3~ ~
6. Valuation of Work: $ ~ j ~~, ~~ Total Sq. Footage p~~lualRg Basement a~a Garagel: Total Finished Area: p?
Floodway ^ Yes
7. FIOOdplain: Fringe Q Yes ^ No Dev. Permit
^ No BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: Q Yes Q No
10. Special Use Permit Required: ^ Yes p No.
11. Variance Required: Q Yes Q No
12. Minimum Setbacks: Front Side Rear
13. Sidewalk Required: Q Yes ~ No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. By my signature below, I acknowledgethat payment
of the building permit application fee does not constitute issuance of this building
permit. I further agree that construction covered by this permitapplication shall not be
commenced until I have received a copy of this application form signed by the Building
Inspector.
I hereby agree to perform the proposed work in accordance with the specifications set
forth above and in accordance with the codes/ordinances of the City of Blair and the
State of Nebraska. I understand thatthis permit is void ifwork is not commenced within
180 days or is not completed within~2 ynear~s of date of issue.
SIGNATURE OF OWNER/CONTRACTOR DATE
Comment:
Q Site Plan Attached ^ Complete Plans Attached
Approximate Completion Date ~" ~ " ~6P
Inspections Required and Fees
iti i
Sewer _
Septic _
B ildin
Footings
~/
Water Service
Remote
Stop Box Card
Drywall
(PRIOR TO TAPING)
Framing Final
EI ri I ~~
Rough-in
Final
Temporary Service
Mechanical
Rough-in _
Final
PI m in -
Ground Work
Rough-in
A\C ,
Final
WHEN PROPERLY VALIDATED (IN THIS
Approved By:
Fixtures
Permanent Service
THIS IS YOUR PERMIT
Rev. 9/96
POUNDS PRTG.-Blair, NE
FROM
(MON)OCT 16 2006 7:46fST, 7:46fNo.7500000754 P
407 S. 16tH St.
Blair, NE 68008
402-426-3890 F426-3790
TO: Phil Green FROM; Bob Johnson a
FD~M: City of T31air F11ZN1; lZJ DEVELOPMENT 1NC.
PHONE: _ PI-I~NE: Iv1510-71.20
FAX; 426-4195 FAX: 426-3790 1
TOTAL PAGES 1NCL, TI~IIS ONE: 1 10/11/06
PRO,TII;CT: Byer Central School Apts.
Phil,
My Architect has finally completed the parking lot Layout and revisions to the
proposed garage to be built on the West parking lot.
What is the procedure for the City and Planning Board to review'? J would like to be
put on the agenda for the next meeting.
~.
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Thanks, LOBJ
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BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected at the time of your building permit
application for all permits $10,0000 and above. However, the City reserves the right
to not refund this deposit if any of the following conditions occur during the
construction period: 1) theft of water service by either the plumber, owner or general
contractor, 2) all required inspections have not been obtained, 3) occupancy occurs
prior to a final inspection, 4) all permits have not been obtained, and 5) the project is
completed without a final inspection being done. If any or all of these situations
occur during construction, you may forfeit your deposit.
I, hereby agree to the above conditions, and understand that should any or all of the
above situations occur, the building permit deposit SHALL be forfeited or discounted
upon the discretion of the City of Blair, Building and Inspections Department.
Contractor/Owner Contractor/ caner
City of Blair
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cifyofblair@huntel.net
CITY OF BI,~~IR
'fir
o~/se of q,
BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet .includes various items dealing with particular code
requirements and/or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2003 International Building
Code requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
I have read the above disclosure and accept this building permit documentation on my
own beh~y~ssumin~ full responsibility as the owner/contractor for this project.
6/0~
Contractor
City of Blair
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail c'rfyofblair@huntel.net ~,,•° m°
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